1: Together, heart disease and cancer account for almost half of all American deaths.
There is a difference, however, between these two killers.
“We understand,” Peter Attia writes in his terrific book Outlive, “the genesis and progression of heart disease fairly well, and we have some effective tools with which to prevent and treat it.
“As a result, mortality rates from cardiovascular disease and cerebrovascular disease have dropped by two-thirds since the middle of the twentieth century.”
2: Cancer, on the other hand, kills Americans at nearly the same rate as it did fifty years ago.
This fact remains “despite well over $100 billion spent on research via the National Cancer Institute, plus many billions more from private industry and public charities—despite all the pink ribbons and yellow bracelets, and literally millions of published papers on the PubMed database,” Peter notes.
There are some bright spots, especially regarding the fight against leukemia. “For adults with leukemia,” Peter writes, “ten-year survival rates nearly doubled between 1975 and 2000, leaping from 23 percent to 44 percent.
“Survival rates for Hodgkin’s and non-Hodgkin’s lymphomas have increased as well, especially the former.”
Cancer and heart disease are both diseases of the aging. “That is, it becomes exponentially more prevalent with each decade of life,” Peter writes.
That said, cancer can be deadly at almost any age.
“The median age of a cancer diagnosis is sixty-six, but in 2017 there were more cancer deaths among people between forty-five and sixty-four than from heart disease, liver disease, and stroke combined.”
The forty-five and sixty-four group also accounts for nearly 40 percent of the estimated 1.7 million new cases of cancer diagnosed in the U.S.
“As I write these words,” Peter reflects, “I reflect sadly on three of my friends from high school who died of cancer in the past ten years, all younger than forty-five. I was able to say goodbye to only one of them before she died. Everyone reading this book probably has a few similar stories.”
3: There are additional challenges we face in our fight against cancer.
First, we lack the ability to detect cancer in its earliest stages. As a result, when detected, in many instances, it has been progressing for years and possibly decades.
“Far too often, we discover tumors only when they cause other symptoms, by which point they are often too locally advanced to be removed—or worse, the cancer has already spread to other parts of the body,” Peter notes.
Many times, we discover tumors only when they generate other symptoms, “by which point they are often too locally advanced to be removed,” Peter notes, “or worse, the cancer has already spread to other parts of the body.”
Second, once cancer is entrenched, “we lack highly effective treatments for it,” Peter writes. “Our toolbox is limited.
“Many (though not all) solid tumors can be removed surgically, a tactic that dates back to ancient Egypt,” he notes. “Combining surgery and radiation therapy is pretty effective against most local, solid-tumor cancers.
But once a cancer has metastasized or begins to spread, it almost always returns, often more resistant to treatment than ever.
“I saw this happen many times during my training,” Peter writes. “We would remove a patient’s tumor (or tumors), only to have them die a year later because the same cancer has taken hold elsewhere, like their liver or their lungs.”
“Our benchmark for success in a patient, or remission, is typically five-year survival, nothing more,” Peter writes. “We don’t dare utter the word cure.”
Despite all these challenges, there are some promising signs in our War Against Cancer. We will cover these topics over the next two days.
More tomorrow!
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Reflection: Do I have a cancer story involving myself, my family, or a close friend? If so, how did this experience impact how I live my life?
Action: Journal about my answers to the questions above.